Rapidly spreading multi-drug resistant yeast: Candida auris

Abstract

Candida auris is a new type of Candida that has been reported in several countries and has been resistant to multiple drugs in a short time since its identification. This fungus, whose natural reservoir cannot be found, is almost exclusively isolated in hospital settings. The actual prevalence of mushroom misidentifiable by conventional methods is therefore not known. As with other Candida species, C. auris causes various invasive infections such as bloodstream infections, urinary tract infection, otitis, surgical wound infections, catheter-associated skin abscesses, myocarditis, meningitis, bone infections and wound infections, and is responsible for many hospital outbreaks. Use of broad-spectrum antibiotics and antifungal agents, diabetes mellitus, abdominal and vascular surgery, presence of central venous catheters, urinary catheterization, postoperative drain placement, chronic kidney disease, chemotherapy, blood transfusions, hemodialysis, total parenteral nutrition, duration of intensive care unit, the immunosuppressive condition also constitutes risk factors for C. auris as in other infections. C. auris; adherence has various virulence factors such as biofilm formation, phospholipase and proteinase enzymes, and infections may result in high mortality. Survival of external surfaces and partial resistance to disinfectants facilitate colonization with fungi and subsequent infection. Most isolates show high at a finding of an elevated minimum inhibitory concentration (MIC) fluconazole and amphotericin B values. Resistance to echinocandins has been reported to differ. Some isolates are resistant to three major antifungal classes and cause persistent infection. In the first-line treatment of C. auris, echinocandin class antifungals are used. In case of resistance to echinocandins, combination therapies are recommended. The general misconfiguration of laboratory diagnoses, resistance to antifungal agents and rapid spread in the global sense arouses concern for this pathogen. The aim of this review is to describe C. auris, a newly described species; microbiological characteristics, virulence factors, antifungal resistance mechanisms and global dissemination are examined to create a clinical awareness.